New diagnosis of COPD

COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; GOLD: Global Initiative for Chronic Obstructive Lung Disease; CAT: COPD Assessment Test; SABA: short-acting beta-agonist; SAMA: short-acting muscarinic antagonist; LAMA: long-acting muscarinic antagonist (anticholinergic); LABA: long-acting beta-agonist; mMRC: Modified Medical Research Council; FEV₁: forced expiratory volume in one second; FVC: forced vital capacity.

* COPD is diagnosed based on the presence of chronic respiratory symptoms (dyspnea, cough, sputum production) accompanied by airflow limitation. All patients with COPD defined by GOLD have airflow limitation based on a reduced FEV₁/FVC ratio <0.70. The severity of airflow limitation is determined by the reduction in FEV₁.

¶ An exacerbation of COPD is characterized by increased dyspnea and/or cough and sputum that worsens in less than 14 days, may be accompanied by tachypnea or tachycardia, and is often caused by infection, environmental irritation, or other insult to the airways. "Moderate exacerbations" are typically defined as those which require treatment with systemic glucocorticoids. More objective severity classifications have been proposed but are difficult to establish via patient history. Please refer to UpToDate content on "COPD exacerbations: Clinical manifestations and evaluation" for additional information.

Δ CAT: http://www.catestonline.org (Accessed on January 12, 2023).

◊ For those prescribed a LABA alone, SAMA-SABA combination therapy is likely to be most potent but will have some of the same side effects as LAMA. For those prescribed a LAMA, SAMA should generally not be used concomitantly, so SABA alone is preferred.